- Molina Healthcare (Tampa, FL)
- …root cause and resolve outstanding issues. Creates reports and analysis based on business needs and required or available data elements. Collaborates with Health ... remediation plans and fixes, overall progress, and status of impacted claims **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or equivalent… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...position will be a communicator to internal and external business partners and a problem solver/agent for change to… more
- Acosta Group (Tampa, FL)
- **DESCRIPTION** This position will be responsible for processing and handling any claims that are incomplete or escalated for validation. This person will also be ... responsible for analyzing claims and making decisions about their validity. The position...position will be a communicator to internal and external business partners and a problem solver/agent for change to… more
- Molina Healthcare (Tampa, FL)
- **Job Description** Job Summary Serves as claims subject matter expert. Assist the business teams with reviewing claims to ensure regulatory requirements are ... appropriately applied. Manages and leads major claims projects of considerable complexity and volume that may be initiated through provider inquiries or complaints,… more
- Molina Healthcare (Tampa, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...in research, review and audits for adjudication rates of claims + Must be able to work in cross… more
- Molina Healthcare (Tampa, FL)
- …**Job Summary** A successful candidate will have a balance of business insight, critical thinking, strong communication and analytical skills. Possess the ... organizational and technical challenges. Performs research and analysis of healthcare claims data, pharmacy data, and external data to derive proper courses… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key ... business issues related to cost, utilization and revenue for...and manage information from large data sources. + Analyze claims and other data sources (eg authorization) to identify… more
- Molina Healthcare (Tampa, FL)
- …data and market knowledge. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... Education** Bachelor's Degree or equivalent combination of education and experience ** Required Experience** + 5-7 years of business or experience system… more
- Elevance Health (Tampa, FL)
- ** Business Information Analyst Sr.** **Location:** This position will work a hybrid model (remote and in office 1 - 2 days per week). Candidates must live within ... miles of one of Elevance's Pulse Point locations. The ** Business Information Analyst Sr.** is responsible for...performance using summary statistical procedures. * Develops and analyzes business performance reports (eg for claims data,… more
- Molina Healthcare (Tampa, FL)
- …Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of business rules as they apply to ... to be housed on databases and ensure adherence to business and system requirements of customers as it pertains...Health Plans. + Must have experience with Benefits configuration, claims + The team is responsible for implementation and… more
- The Cigna Group (Tampa, FL)
- …the office or visit Providers 3 days per week** The **Provider Contracting Lead Analyst ** serves as an integral member of the Provider Contracting Team and reports ... of communication with matrix partners including but not limited to, Claims Operations, Medical Management. Credentialing, Legal, Medical Economics, Compliance, Sales… more
- Bank of America (Tampa, FL)
- Senior Fraud Analyst II - Fraud Detection - Digital Tampa, Florida **Job Description:** At Bank of America, we are guided by a common purpose to help make financial ... controls + Records data captured during client interactions accurately ** Required Qualifications:** + Strong analytical and organizational skills and demonstrated… more
- Molina Healthcare (Tampa, FL)
- …data and vendor competencies. Creates specifications for reports and analysis based on business needs and required or available data elements. Collaborates with ... **Job Description** **Job Summary** Supports ongoing Claims and Enrollment operations in the management of...+ Must be able to lead meetings **Job Qualifications** ** REQUIRED EDUCATION:** Bachelor's degree in Business or… more
- MUFG (Tampa, FL)
- …US compliance regulation checks/screening/data entry; and (h) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, ... Laws)/FEFTA /Red flags/vessels/shipping lines/ports/country violations relating to trade finance documents/ claims /transactions. **Transaction Processing in Trade 360 System** : Prepare… more
- MUFG (Tampa, FL)
- …US compliance regulation checks/screening/data entry; and (c) acceptances/payments, Reimbursement claims . To assist the Section in achieving its planned objectives, ... Laws) /Red flags/vessels/shipping lines/ports/country violations relating to trade finance documents/ claims /transactions. **Transaction Processing in Trade 360 System** : Prepare… more
- Molina Healthcare (Tampa, FL)
- …systems to support the departments goals. + SQL, Databricks, Python + Claims knowledge/QNXT **JOB QUALIFICATIONS** ** Required Education** Associate's Degree or ... used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. Gains insight into key business problems and deliverables… more
- Molina Healthcare (Tampa, FL)
- …analyses on a variety of topics related to the overall support of business operations. + Creates and maintains reports to manage claim inventory, adjustment ... findings and may develop recommendations to solve problems and issues related to business operations. + Follows team coding standards for report design. Works to… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Computer Science **… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and ... Analyzing Financial and Utilization Metrics of Healthcare. **JOB QUALIFICATIONS** ** Required Education** Bachelor's Degree in Finance, Economics, Math, Computer… more
- Molina Healthcare (Tampa, FL)
- …opportunities to support clinical savings initiatives. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze claims and authorization data to identify trends or other issues ... exhibits and data visualizations to illustrate key trend drivers + Work with business owners to track performance indicators of medical interventions + Extract and… more